Skin cancer occurs when skin cells are damaged, for example, by overexposure to ultraviolet (UV) radiation from the sun.

There are three main types of skin cancer:

• Basal cell carcinoma
• Squamous cell carcinoma
• Melanoma – the most dangerous form of skin cancer.

Both basal cell carcinoma and squamous cell carcinoma are known as non-melanoma skin cancer or keratinocyte cancers. Keratinocyte cancer is more common in men, with almost double the incidence compared to women.

Melanoma is the third most common cancer in Australians excluding keratinocyte cancers as data on incidence is not routinely collected).

Every year, in Australia:

• Skin cancers account for around 80% of all newly diagnosed cancers
• The majority of skin cancers are caused by exposure to the sun
• The incidence of skin cancer is one of the highest in the world, two to three times the rates in Canada, the US and the UK.

Learn more about how Cancer Council funded researchers are working on curing Australia’s national cancer.

Basal cell carcinoma (BCC)

This is the most common but least dangerous form of skin cancer. It grows slowly, usually on the head, neck and upper torso. It may appear as a lump or dry, scaly area. It can be red, pale or pearly in colour. As it grows, it may ulcerate or appear like a sore that does not heal properly. The earlier BCC is detected, the easier it is to treat.

Squamous cell carcinoma (SCC)

This type of skin cancer is not as dangerous as melanoma but may spread to other parts of the body if not treated. It grows over some months and appears on skin most often exposed to the sun. It can be a thickened, red, scaly spot that may bleed easily, crust or ulcerate.

Melanoma

Melanoma can grow quickly. The most aggressive forms can become life-threatening in as little as six weeks and if untreated, it can spread to other parts of the body.

Use the ABCDE rule to look for melanoma where:

• A = asymmetry, look for spots that are asymmetrical not round
• B = border, look for spots with uneven borders
• C = colour, look for spots with an unusual or uneven colour
• D = diameter, look for spots that are larger than 7 mm
• E = evolution, look for any changes to spots on your skin, and see your doctor as soon as possible if you notice any changes.

The earlier melanoma is found, the more successful treatment is likely to be.

Melanoma is often related to a pattern of irregular high sun exposure, including episodes of sunburn.Superficial spreading melanoma (the most common type of melanoma)

It is usually flat with an uneven smudgy outline, may be blotchy and more than one colour – brown, black, blue, red or grey.

Nodular melanoma

A highly dangerous form of melanoma that looks different from common melanomas – they are raised from the start and have an even colouring (often red or pink and some are brown or black). This type of melanoma grows very quickly and needs to be treated as soon as possible. They are most common in older people in sun exposed areas such as the face, ears, neck and head.

Other forms of melanoma include lentigo maligna melanoma, acral lentiginous melanoma and desmoplastic melanoma.

Melanoma skin cancer incorporates ICD-10 cancer code C43 (Malignant neoplasm of skin).

The sooner a skin cancer is identified and treated, the better your chance of avoiding surgery or, in the case of a serious melanoma or other skin cancer, potential disfigurement or even death.

It is also a good idea to talk to your doctor about your level of risk and for advice on early detection.

Become familiar with the look of your skin, particularly spots and moles, so you pick up any changes that might suggest a skin cancer.
Look for:

• Any crusty, non-healing sores
• Small lumps that are red, pale or pearly in colour
• New spots, freckles or any moles changing in colour, thickness or shape over a period of weeks to months.

Skin cancer identification poster

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Australia has one of the highest rates of skin cancer in the world. Anyone can be at risk of developing skin cancer, though the risk increases as you get older.

The majority of skin cancers in Australia are caused by exposure to UV radiation in sunlight.

Some factors that increase your risk of skin cancer include:

• Sunburn
• Tanning
• Solariums.

Who is at risk?

It is important to check your skin regularly and check with your doctor if you notice any changes.

In the majority of cases, your GP will examine you, paying attention to any spots that may look suspicious. Your GP may perform a biopsy (remove a small sample of tissue for examination under a microscope). In some cases your GP may refer you to a specialist, such as a dermatologist, if necessary.

Biopsy

If you notice any significant changes to your skin, your doctor may examine you. Diagnosis is by biopsy (removal of a small sample of tissue for examination under a microscope)

The type of treatment depends on the type and size of the cancer and where it is located.         

Surgical

The main aim of surgical treatment for skin cancer is to remove the lesion with appropriate clinical margin. This clinical margin will depend on the type of skin cancer, site and any additional risk feature identified in the biopsy.

The type of surgery will depend on the type of skin cancer, size and its location on the body. This could include:

• Simple Excision – usually in shape of ellipse
• Complex Excision – requiring flaps, graft and other complex surgical procedures

Doctors at our clinic are well experienced in simple and complex procedures including flaps and grafts to provide the best possible outcome for our patients.

Non-surgical

Common non-surgical treatments in Skin Cancer care are:

• Photodynamic Therapy – not available at our clinic
• Efudix
• Aldara
• Cryotherapy

These options can be used for specific type of lesions only, your doctor will discuss this with you for clinically appropriate lesions.

Follow-up care and wound care

Our experienced nurses will apply appropriate dressing after the surgery and arrange a follow-up appointment for wound review. This might very between 1-5 days depending on the type and complexity of surgery. We will provide you information sheet for your wound care depending on the type of surgery you had.